Do college campuses still need COVID-19 surveillance testing?

Duke, Cornell and the University of Illinois (Urbana-Champaign) conducted widespread COVID-19 surveillance testing during the 2020-2021 academic year. As of early March 2021, Cornell had 645 positive cases amongst students, faculty and staff, while Duke had 639 cases and the University of Illinois had 6,122 positive cases. All of these institutions regularly reported positivity rates under 1 percent, yet their population infection rates were dramatically different; 4 percent for Cornell, around the same for Duke, and over 20 percent for the University of Illinois. All these schools have remained open during the entire academic year, using a variety of in-person and remote education strategies.  

Other schools like Yale, Notre Dame, University of Georgia and the University of Delaware have also embraced surveillance testing for their campus. 

Did all these schools make the right decision to invest in surveillance testing? 

Playing Monday morning quarterback is easy. During the Fall 2020 semester, around 400,000 confirmed COVID-19 cases were reported across college campuses, with 90 deaths, mostly faculty and staff, with just a handful of students. This data indicates that the direct COVID-19 health risk to students was negligible, with 50-64-year-olds no less than four times more likely to be hospitalized due to COVID-19 than college students. Students quickly figured this out, defying public health protocols resulting in pockets of infection surges, many in fraternities and sororities, as well as off-campus housing.  

To keep colleges open required the college’s education infrastructure to be preserved. This meant that faculty and staff had to be protected so they could deliver the college’s education product. Many faculty opted to or were required to teach remotely, using zoom and similar technologies.  

Therefore, the primary beneficiaries of COVID-19 surveillance testing were faculty and staff, who gained peace-of-mind as they continued to work. They assumed the largest amount of health risk if infected, including the risk of hospitalization and death. 

With vaccine availability expanding, the preponderance of faculty and staff will be vaccinated long before students return to campus in August. Many college students will also be vaccinated, creating a critical public health layer of protection for everyone on campus.   

The question then becomes, is COVID-19 surveillance testing still needed? 

The answer depends on the value that surveillance testing brings to a campus in the new environment.   

If the current Pfizer, Moderna and Johnson and Johnson vaccines continue to prove as effective as they have been, surveillance testing brings minimal, if any value, to a campus. If the percentage of vaccinated people on campuses reach herd immunity levels, believed to be around 80 to 90 percent, epidemic infection growth will be dampened, with the most likely scenario being small pockets of infections occurring, mostly amongst those not vaccinated.    

On the other hand, if the vaccines prove to be less effective against new virus variants like B.1.1.7 or B.1351, then the threshold for herd immunity will likely not be crossed, resulting in surging outbreaks that may seep into the faculty and staff population, as well as the surrounding community. In such an environment, surveillance testing will provide much-needed information to keep faculty and staff as safe as possible. 

With so many unknowns between now and August, the fall 2021 semester will continue to challenge colleges as they stick their toe in the waters of in-person education. Although plans are in place to minimize risk, the coronavirus has proven to be a formidable adversary and social disrupter. Much depends on widespread vaccination, including college students, and collaborative cooperation to suppress the spread of the virus and keep one step ahead of it. In such an environment, surveillance testing will provide limited value.   

Sheldon H. Jacobson, PhD, is a founder professor of Computer Science at the University of Illinois at Urbana-Champaign. He applies his expertise in data-driven risk-based assessment to evaluate and inform public policy.